What is the difference between Cutera Excel V vs PicoSure? Do the PicoSure laser pens work on varicose veins?

You likely need to try a combination of a 1064 (genesis or aerolase) plus VBeam or IPL.  Likely you will not get full improvement and need life long treatments given your skin type and "flushing."  Also i would suggest a hormonal workup.  Best, Dr. Emer.

I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination approach, using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

I recommend following up with a cosmetic dermatologist for after care recommendations. We have a specific protocol. I recommend skin care with vitamin c, b5 hydrator, silicone based scar gels with growth factors and enzymatic washes with papaya enzyme to give improvement. PDT therapy can calm i...

Excel V is an excellent laser for vascular lesions, and it can improve the pigmentation to certain extent in an expert hand. Enlighten laser is much better than Excel V for pigmentation. You have not displayed your before photos, it is possible you have melasma and may be what you are seeing i...

Lasers generally create intense heat and when the settings are high or there are multiple passes, they can cause both additional pigmentation and/or loss of pigmentation. Thankfully, this is not a typical side effect, but it does happen. Aggressive treatments aren't always a good choice if you d...